Lipocura München | Dr. von Lukowicz berät seine Patientin

What is lipoedema and what are the symptoms?

Lipoedema is a symmetrical increase in fat that usually occurs in the legs, the buttocks and the arms and normally only affects women. With this illness, the distribution of fat in the body is impaired; it is not – as was long believed – a consequence of overweight. In addition to fluid retention, patients suffer from severe tension pain, which in many cases is accompanied by increased bruising and pressure pain in the affected areas. The leg becomes consistently large and heavy, most often from the hip down to the ankle. The lipoedema can also occur at the upper arms, whereas the patient’s torso, hands and feet remain slim.

A lot of women suffer from so-called “saddlebags” at first, a persistent accumulation of fat in the area between the buttocks and the thighs. In the further course of the disease, these accumulations can become larger and increasingly visible. This impairment of the distribution of fat can occur at an early age, in combination with hormonal fluctuations following a pregnancy or else at the beginning of menopause.

Apart from the aesthetical aspect, the physical strain also plays an important part. Patients often suffer from severe tension pain and increasing touch sensitivity – not to mention the limited mobility caused by badly swollen legs. The psychological aspect should not be neglected, either. In most cases, people do not realize that the person concerned suffers from lipoedema and that the excess of fat has not been caused by overweight and a lack in discipline.

The different stages of lipoedema

Lipoedema is categorized into four stages that describe the structure of the tissue and the texture of the skin. With this conventional classification system, a very important parameter of lipoedema, that is to say pain, is not taken into consideration. Even in Stage I, in which the surface of the skin still seems very smooth, patients can already suffer from severe pain in the extremities, which make long periods of walking and standing impossible. Such conditions have to be treated in a different way from those of a patient who is in no or hardly any pain.

Classification system

Stage I: smooth surface of skin, thickened subcutaneous fat, finely nodular fat structure.

Stage II: uneven surface of skin, coarsely nodular fact structure.

Stage III: tissue also more solid and hard, broadly lobed deforming fat lobes.

Stage IV: lipo-lymphedema with increased fluid retention.

Classification according to types

In contrast to the classification system that takes the condition of the skin and tissue into consideration, the classification according to types focuses on the affected areas of the body.

Type 1: increase in fat tissue at buttocks and hips (saddlebags phenomenon).

Type 2: the lipoedema reaches to the knees, formation of fat lobes on the insides of the knees.

Type 3: the lipoedema reaches from the hip to the ankles.

Type 4: arms and legs are affected to the wrists / ankles, i.e. excluding feet and hands.

Lipoedema can be very painful and restrict everyday life. A lot of women therefore try out new diets time and again, but legs, arms and desperation continue to grow. If you suspect that you are suffering from lipoedema, please do not hesitate to come to our surgery. We are experts in this area, can confirm the findings and recommend gentle treatment methods, which we can carry out in our Munich surgery. In some cases, it might be advisable to call in a phlebologist in addition to our assessment, to test for and ideally exclude any venous disorders.

Please find the fol­lo­wing lipo­edema check­list and our frequently asked questions (FAQs) to cla­rify the most import­ant ques­ti­ons about lipo­edema.